Epidemiological characteristics of tuberculosis incidence and its macro-influence factors in Chinese mainland during 2014-2021

BACKGROUND

Tuberculosis (TB) remains a pressing public health issue, posing a significant threat to individuals' well-being and lives. This study delves into the TB incidence in Chinese mainland during 2014-2021, aiming to gain deeper insights into their epidemiological characteristics and explore macro-level factors to enhance control and prevention.

METHODS

TB incidence data in Chinese mainland from 2014 to 2021 were sourced from the National Notifiable Disease Reporting System (NNDRS). A two-stage distributed lag nonlinear model (DLNM) was constructed to evaluate the lag and non-linearity of daily average temperature (℃, Atemp), average relative humidity (%, ARH), average wind speed (m/s, AWS), sunshine duration (h, SD) and precipitation (mm, PRE) on the TB incidence. A spatial panel data model was used to assess the impact of demographic, medical and health resource, and economic factors on TB incidence.

RESULTS

A total of 6,587,439 TB cases were reported in Chinese mainland during 2014-2021, with an average annual incidence rate of 59.17/100,000. The TB incidence decreased from 67.05/100,000 in 2014 to 46.40/100,000 in 2021, notably declining from 2018 to 2021 (APC = -8.87%, 95% CI: -11.97, -6.85%). TB incidence rates were higher among males, farmers, and individuals aged 65 years and older. Spatiotemporal analysis revealed a significant cluster in Xinjiang, Qinghai, and Xizang from March 2017 to June 2019 (RR = 3.94, P < 0.001). From 2014 to 2021, the proportion of etiologically confirmed cases increased from 31.31% to 56.98%, and the time interval from TB onset to diagnosis shortened from 26 days (IQR: 10-56 days) to 19 days (IQR: 7-44 days). Specific meteorological conditions, including low temperature (< 16.69℃), high relative humidity (> 71.73%), low sunshine duration (< 6.18 h) increased the risk of TB incidence, while extreme low wind speed (< 2.79 m/s) decreased the risk. The spatial Durbin model showed positive associations between TB incidence rates and sex ratio (β = 1.98), number of beds in medical and health institutions per 10,000 population (β = 0.90), and total health expenses (β = 0.55). There were negative associations between TB incidence rates and population (β = -1.14), population density (β = -0.19), urbanization rate (β = -0.62), number of medical and health institutions (β = -0.23), and number of health technicians per 10,000 population (β = -0.70).

CONCLUSIONS

Significant progress has been made in TB control and prevention in China, but challenges persist among some populations and areas. Varied relationships were observed between TB incidence and factors from meteorological, demographic, medical and health resource, and economic aspects. These findings underscore the importance of ongoing efforts to strengthen TB control and implement digital/intelligent surveillance for early risk detection and comprehensive interventions.

The status and influencing factors of abnormal fetal pregnancy outcomes in 265 cases in China: a retrospective study

Background

With the advancement of prenatal diagnosis technology, the detection rate of fetal abnormalities continues to increase, imposing a significant burden on both society and families. A retrospective analysis of essential information about pregnant women, such as their pregnancy history and delivery details, is crucial for understanding the primary factors that influence pregnancy outcomes in women with fetal abnormalities. This analysis is of great significance for improving the level of pregnancy management and outcomes in pregnant women with fetal abnormalities.

Objective

To retrospectively analyze the pregnancy outcomes of women with fetal abnormalities and explore the factors that influence these outcomes.

Methods

Pregnant women's pregnancy outcomes were collected from the medical information system and through telephone follow-ups. The chi-square test and logistic regression were used to analyze the factors influencing pregnancy outcomes.

Results

Among 265 pregnant women diagnosed with fetal abnormalities, 190 chose to continue the pregnancy, while 75 chose to terminate it. Pregnant women with multiple fetal abnormalities (OR = 3.774, 95% CI [1.640-8.683]) were more likely to choose termination of pregnancy (TOP), and pregnant women who were advised to terminate their pregnancy or make a careful choice were more likely to terminate the pregnancy (OR = 41.113, 95% CI [11.028-153.267]).

Conclusion

The number of organs involved in fetal abnormalities and treatment recommendations were identified as the primary factors influencing pregnancy outcomes. Improving awareness of maternal health care during pregnancy, early pregnancy screening technology, and a multidisciplinary diagnosis and treatment approach are of great significance in assisting pregnant women in making informed decisions and improving fetal prognosis.

Recent advances in the contribution of glucosinolates degradation products to cruciferous foods odor: factors that influence degradation pathways and odor attributes

As one of the most important vegetables and oils consumed globally, cruciferous foods are appreciated for their high nutritional value. However, there is no comprehensive knowledge to sufficiently unravel the "flavor mystery" of cruciferous foods. The present review provides a comprehensive literature on the recent advances regarding the contribution of glucosinolates (GSL) degradation products to cruciferous foods odor, which focuses on key GSL degradation products contributing to distinct odor of cruciferous foods (Brassica oleracea, Brassica rapa, Brassica napus, Brassica juncea, Raphanus sativus), and key factors affecting GSL degradation pathways (i.e., enzyme-induced degradation, thermal-induced degradation, chemical-induced degradation, microwave-induced degradation) during different processing and cooking. A total of 93 volatile GSL degradation products (i.e., 36 nitriles, 33 isothiocyanates, 3 thiocyanates, 5 epithionitriles, and 16 sulfides) and 29 GSL (i.e., 20 aliphatic, 5 aromatic, and 4 indolic) were found in generalized cruciferous foods. Remarkably, cruciferous foods have a distinctive pungent, spicy, pickled, sulfur, and vegetable odor. In general, isothiocyanates are mostly present in enzyme-induced degradation of GSL and are therefore often enriched in fresh-cut or low-temperature, short-time cooked cruciferous foods. In contrast, nitriles are mainly derived from thermal-induced degradation of GSL, and are thus often enriched in high-temperature, long-time cooked cruciferous foods.

Evaluation of antibacterial activity and influencing factors of normal and nanostructured copper-based materials

Background

Copper-based materials have garnered extensive recognition for their effective nature against microorganisms and their minimal toxicity. However, the evaluation for their antibacterial activity is still in its nascent stages, and the evaluation results based on existing criteria are not representative of real-world application.

Aim

To evaluate the antibacterial activity and primary determinants of influence of copper-based materials in order to investigate their practical antibacterial activity and potential mechanisms of such materials.

Methods

Staphylococcus aureus and Escherichia coli bacterial suspensions were applied via inoculation onto the surfaces of normal and nanostructured copper foil. Following incubation of the inoculated surfaces under diverse experimental conditions-including varying compositions of the bacterial suspension, the use of chemical neutralizers, the existence of organic interferents, and low temperature and humidity-surviving bacteria were enumerated. Using the scanning electron microscopy and X-ray photoelectron spectroscopy, the surface changes of copper-based materials were examined.

Findings

Following 1 h of exposure to 37 °C and 90% relative humidity, Staphylococcus aureus was reduced by 4.45 log10 on normal copper foil, while all of the bacteria were eradicated on nanostructured copper foil. In addition, it was discovered that preparing a bacterial suspension with PBS results in a significant number of Escherichia coli fatalities during the test, whereas using TPS promotes the bacteria's normal growth. Furthermore, the outcomes of the antibacterial activity test were diminished when chemical neutralization was employed, and the presence of organic interferents had distinct impacts on normal copper foil and nanostructured copper foil. Additionally, low temperatures and humidity diminished the antibacterial activity of copper foil, whereas normal copper foil produced significantly better results.

Conclusion

While copper-based materials exhibit robust antibacterial activity as determined by standard assays, their efficacy in real-world applications is subject to various influencing mechanisms. In order to objectively evaluate the antibacterial activity of copper-based materials and provide precise guidance for their development and practical application, it is essential to regulate test conditions with targeted.

Occurrence characteristics, environmental trend, and source analysis of polycyclic aromatic hydrocarbons in the water environment of industrial zones

The middle reaches of the Yellow River are rich in energy resources, with the Kuye River, a first-class river in this region, serving as a vital hub for the coal chemical industry within China. This study investigated the occurrence patterns, environmental trends, and ecological risks associated with polycyclic aromatic hydrocarbons (PAHs) in the Kuye River Basin, offering insights into the environmental dynamics of regions. The findings indicated that the river sediments primarily contained PAHs with medium to high-molecular weights, exhibiting levels ranging from 402.92 ng/g dw to 16,783.72 ng/g dw, while water bodies predominantly featured PAHs with low to medium molecular weights, ranging from 299.34 ng/L to 10,930.9 ng/L. The source analysis of PAHs indicated that industrial and traffic exhaust emissions were the primary contributors to PAHs in the Kuye basin, with sediments serving as a secondary release source based on fugacity fraction. The content of PAHs in sediment correlated closely with the environmental factors, and the PAHs inventory of the basin was 19.97 tons. The increased overall PAH concentration in the basin posed significant ecological and public health concerns, necessitating urgent attention.

Monitoring grey water footprint and associated environmental controls in agricultural watershed

The grey water footprint (GWF) is an advanced index linking pollution load and water resources. However, the existing agriculture-related GWF was developed based on hydrological processes, which limits its role in watershed water pollution level (WPL) measurements. The main scope of this study is to calculate GWF and WPL based on runoff, total nitrogen (TN), and total phosphorus (TP) observations in the Hujiashan Watershed of China's Yangtze River Basin. Partial least squares structural equation modeling (PLS-SEM) was utilized to explore the impact pathways of environmental features on GWF and WPL. On this basis, propose measures for the management of this agricultural watershed. The results showed that the TN concentration had a V-shaped trend in 2008-2015, while the TP gradually decreased. The GWF calculations for the TN and TP were compatible with the temporal trends for the concentrations, which were higher in the wet season (0.45 m3/m2 for TN, 0.10 m3/m2 for TP) than in the dry season (0.11 m3/m2 for TN, 0.02 m3/m2 for TP) and increased from upstream to downstream. The WPLs of TN exceeded 2.0 in the midstream and downstream areas, whereas those for TP were inconspicuous. According to PLS-SEM, the GWF is primarily influenced by topographical variables and hydrological features, whereas the WPL is mainly controlled by hydrological features and landscape composition. Fertilizer reduction and efficiency measures should be implemented on farmland and appropriately reducing farming activities on slopes to relieve the GWF and WPL in the watershed.

Modelling based study on the occurrence characteristics and influencing factors of the typical antibiotics in Bohai Bay

Previous studies have demonstrated that antibiotics have the potential impacts to ecosystems and human health. However, due to their various classes and distinct characteristics, creating comprehensive, integrated and dynamic simulations has proven to be a challenging task. In this study, a 3D hydrodynamic-contaminant model was developed to gain a better understanding of the transportation and prevalence of antibiotics in the Bohai Bay. Specifically, we focused on four types of antibiotics as examples. To accurately capture the dynamic distribution of antibiotics, both transport and biochemical processes were taken into account. Based on this model, the antibiotics' spatial and temporal distribution was examined, the potential impact of the future antibiotics consumption and climate change was also analyzed. The study found that human activity has a greater impact on the presence of antibiotics in Bohai Bay than temperature rise. Based on the current consumption rate, the total amount of antibiotics in Bohai Bay may increase by 10 ng/L and affect nearly one third of the study area within the next 20-30 years. The significant impact of human activity on water contamination in coastal areas may also have implications for other coastal regions. This finding can provide a valuable framework for pollution prevention and control.

Application of Anderson model to analyze the influencing factors of lung function test behavior in middle-aged and elderly people in China

Introduction

Lung function tests are valuable in assessing respiratory health and disease, and the Healthy China Initiative clearly states that people over 40 years of age should have a lung function test once a year. To explore the influence of propensity factors, ability factors, and need factors on lung function detection behaviors of middle-aged and elderly Chinese, the following studies are conducted.

Method

A questionnaire was designed using Anderson's model, and multi-stage sampling was used to conduct a nationwide questionnaire survey based on geographical subdivisions and population distribution. Frequency and percentages were used for descriptive statistical analysis of lung function testing among middle-aged and elderly people in China, and chi-square tests and binary logistic regression analyses were used to investigate the factors influencing lung function testing behavior among middle-aged and elderly people in China.

Result

A total of 404 study participants were included in this study. Education level (relative to primary school and below, middle school and high school and secondary school OR = 2.652, P = 0.018; college and above OR = 4.566, P = 0.002), mode of health care affordability (relative to those who paid for the test, non-payers OR = 2.205, P = 0.004), dimensions of the European Five Dimensional Health Scale (mobility OR = 4.571, P = 0.006; pain or discomfort OR = 0.397, P = 0.003; anxiety or depression OR = 0.511, P = 0.028), and self-efficacy (medium group 0R = 0.294, P < 0.001; low group OR = 0.162, P = 0.003) had a significant impact on lung function testing behavior in our middle-aged and older adults.

Conclusion

This study found that there is still room for improvement in the participation of middle-aged and elderly people in lung function testing. Among the propensity factors, the factor that affects the rate of lung function tests is the highest degree of education, which determines the degree of patients' attention to lung function tests. Among the need factors, the factors affecting the rate of lung function detection are the physical conditions of middle-aged and elderly people, and those with poor physical conditions need medical detection. Among the ability factors, the factor that affects the rate of lung function tests is the way of bearing medical expenses, and economic status is the key factor that determines whether patients can accept lung function tests.

Factors affecting the accumulation of organotins by wild fish: A case study in the Three Gorges Reservoir, China

Organotin compounds (OTs) accumulate in fish easily, however, research on their influencing factors is still limited. This study collected 25 species of fish with different diets, habitats, and age from the Three Gorges Reservoir (TGR), the largest deep-water river channel-type reservoir in China, and analyzed the accumulation characteristics of OTs in these fish. The results showed that tributyltin (TBT) and triphenyltin (TPhT) were the dominant OTs in fish from the TGR. The correlation between OTs concentration and age, body length, and body weight varied with fish species. The concentrations of TBT and TPhT in carnivorous fish (mean, 25.78 and 11.69 ng Sn/g dw, respectively) were higher than those in other diet fish (P<0.01), but there was no significant difference in fish at different habitat water layers (P>0.05). In addition, the degradation rates of TBT and TPhT in different fish species were all below 50%. In summary, the accumulation of TBT and TPhT in fish is mainly influenced by diet, and both TBT and TPhT were difficult to degrade in fish. These results reveal the pollution characteristics of OTs in fish from the TGR, and can improve our understanding of the factors influencing TBT and TPhT accumulation in freshwater fish.

Atmospheric phthalate esters in a multi-function area of Hangzhou: Temporal variation, gas/particle phase distribution, and population exposure risk

Phthalate esters (PAEs) are prevalent in both indoor and outdoor environments. However, there are relatively few studies on phthalate contamination in the air of multi-function areas. Experiments were conducted to analyze the concentrations of 14 distinct PAEs in outdoor air in the college town of Hangzhou throughout both the warm and cold seasons. Correlation and principal component analyses were performed to investigate the influence and source factors of PAEs. This study also focused on the relationship between the gas/particle partition coefficient Kp and temperature, as well as the application of the gas/particle partition model. The risk of exposure to PAEs via inhalation was predicted for four groups of the general population: toddlers, adolescents, adults, and older adults. The results indicated that the concentration levels of Σ14PAEs in outdoor air were 1573 ng/m3 in the gaseous phase and 126 ng/m3 in the particulate phase. Additionally, this study indicated three primary sources of PAEs: indoor diffuse sources, industrial emission sources, and building construction sources. The gas/particle partitioning of PAEs also revealed that low-molecular-weight PAEs are more prevalent in gas, whereas high-molecular-weight PAEs are more predominant in the particle phase. A health risk analysis revealed high estimations of daily intakes (EDI) for toddlers and adolescents and high lifetime average daily doses (LADD) for older adults. This study establishes a solid foundation for formulating scientific and effective air pollution control measures by analyzing the characteristics and assessing the health risks of PAEs.

Family resilience in cancer treatment and key influencing factors: A systematic review

OBJECTIVE

To identify the status quo and key influencing factors of family resilience in cancer treatment.

METHODS

Eight electronic databases (PubMed, Cochrane Library, Embase, CINAHL, Web of Science, CNKI, Wan Fang Database, VIP Database) were searched from 2000 to 10 May 2023. Inclusion criteria were the following: (a) study subjects were cancer patients or their family caregivers, (b) family resilience was measured as a variable, (c) reported factors associated with family resilience, (d) employed either quantitative or mixed methods design, (e) written in English or Chinese, (f) published in peer-reviewed journals. All included studies were evaluated for quality using the Mixed Method Appraisal Tool.

RESULTS

Thirty studies were included in the systematic review. According to our analysis, the family resilience of cancer patients could be influenced by various factors associated with six clusters: (a) demographic characteristics, (b) severe staging and treatment of cancer, (c) psychological and health statuses, (d) family, and (e) social environment. Meanwhile, several specific protective factors and risk factors of family resilience were also identified.

CONCLUSION

Family resilience plays an important role in promoting positive adaptation in the face of adversity in families of cancer patients/caregivers. This study classifies related influencing factors by analyzing both protective factors and risk factors (and some controversial factors of family resilience). We found that longitudinal studies are needed to further verify the dynamic changes of family resilience, and future research should focus on understanding family resilience from the dual perspectives of cancer patients and their caregivers, to provide comprehensive information for health professionals, and facilitate the development of effective family resilience intervention programs.

Advanced nanopesticides: Advantage and action mechanisms

The use of various chemical substances to control pests, diseases, and weeds in the field is a necessary part of the agricultural development process in every country. While the application of pesticides can improve the quality and yield of crops, plant resistance and the harm caused by pesticide residues to the environment and humans have led to the search for greener and safer pesticide formulations to improve the current situation. In recent years, nanopesticides (NPts) have shown great potential in agriculture due to their high efficiency, low toxicity, targeting, resistance, and controlled slow release demonstrated in the experimental stage. Commonly used approaches to prepare NPts include the use of nanoscale metal materials as active ingredients (AI) (ingredients that can play a role in insecticide, sterilization and weeding) or the construction of carriers based on commonly used pesticides to make them stable in nano-sized form. This paper systematically summarizes the advantages and effects of NPts over conventional pesticides, analyzes the formation and functions of NPts in terms of structure, AI, and additives, and describes the mechanism of action of NPts. Despite the feasibility of NPts use, there is not enough comprehensive research on NPts, which must be supplemented by more experiments in terms of biotoxicology and ecological effects to provide strong support for NPts application.

Effects of comprehensive landscape patterns on water quality and identification of key metrics thresholds causing its abrupt changes

Comprehensive landscape patterns influence water quality with multiple factors, complex processes, and scale dependence. However, studies identifying landscape thresholds causing abrupt water quality changes and characterizing the contribution of topography to water quality are still limited. Exploring the impact mechanisms of natural geographical and landscape characteristics on spatial and seasonal water quality variations is conducive to watershed water resource protection and ecosystem restoration. Based on water quality monitoring data of Minjiahe River in the typical headwater area of the upstream Dan River in China from 2019 to 2021, we employed redundancy analysis, partial redundancy analysis, and nonparametric change-point analysis to analyze the relationship between stream water quality and multi-spatial scale comprehensive landscape patterns, to obtain the interactive and independent contributions of different landscape categories at multi-spatial scales on water quality, and to find the key landscape threshold leading to abrupt changes in water quality. Results showed that landscape configuration, landscape composition, and topographic factors collectively explain over 89.1% of water quality variation. Most seasonal variations in water quality were primarily caused by landscape configuration. The landscape composition was mainly responsible for the differences in water quality variations among spatial scales. The topographic factors made the least independent contribution and had a potential impact on overall water quality variation. In order to protect the water quality of streams, it is more reasonable to regulate the landscape at different scales. At the sub-catchment scale, interspersion and juxtaposition index (IJI) and landscape shape index (LSI) should be controlled below 82% and 22. At the 100 m riparian scale, farmland, urban land, IJI, and LSI should be controlled below 29%, 6.5%, 92%, and 26, respectively. Our results provide important guidance for optimizing landscape patterns and water conservation in the watershed.

Influence of vehicle and pavement characteristics on dust resuspension from soil pavement of open-pit mine

It is essential to explore the distribution characteristics of dust concentration distribution near the surface of soil pavement in open-pit mines to develop effective dust control measures. Therefore, in this study, the dust resuspension process of soil pavement was analyzed by building the dust resuspension experimental system of open-pit mine, and the change rules of dust concentration under different factors were investigated. The results showed that under the action of wheel rolling, the dust moved around the wheel along the vertical direction, and the diffusion trajectory in the horizontal direction was approximately parabolic. After re-suspension of the open-pit mine soil pavement, the area of high dust concentration behind the wheel is roughly triangular. The relationship between the average dust concentration (Total dust, Respirable dust and PM2.5) and the vehicle speed and weight were fit to a power function, while the relationship with silt content and water content were quadratic. Vehicle speed and water content had significant effect on the total dust, respirable dust (RESP) and PM2.5 average concentration, while vehicle weight and silt content had little effect on the respirable dust and PM2.5 average concentration. When the water content of mine soil pavement reached 3 %, the average dust concentration could be reduced to <10 mg/m³, and the vehicle speed should be reduced as much as possible under the mine production permitting conditions.

Spatiotemporal distribution and potential sources of atmospheric microplastic deposition in a semiarid urban environment of Northwest China

In this study, the spatiotemporal distribution of microplastic deposition was investigated through ordinary Kriging interpolation, and the potential sources of microplastic deposition were identified by using Hybrid Single-Particle Lagrangian Integrated Trajectory model. The results showed that the total deposition flux of microplastics ranged from 79.5 to 810.0 p/(m²·d). The shapes of microplastics could be divided into 4 shapes: fiber, fragment, film, and pellet. Seven polymer types of microplastics were identified, including polyamide (PA), polyethylene (PE), polyethylene terephthalate (PET), polymethyl methacrylate (PMMA), polypropylene (PP), polystyrene (PS), and polyvinyl chloride (PVC). Most microplastics were tiny and small sizes (≤ 500 μm) and colorless. Through model analysis and survey, microplastic deposition came from the study region, and the potential sources might be plastic products and wastes. The seasons with the highest and lowest total deposition flux were summer (535.5 p/(m²·d)) and winter (197.5 p/(m²·d)), respectively. The months of the highest and lowest total deposition flux were June 2021 (681.4 p/(m²·d)) and January 2022 (112.2 p/(m²·d)), respectively. Most fibers (PET, PA, PP) and fragments (PP) were distributed in populous areas such as commercial centers and residential areas. Abundant fragments (PET, PS, PE) and films (PE, PVC) were distributed around salvage stations. Almost all of the pellets (PE, PMMA) were found in the factory. Our results suggested that the temporal distribution of microplastic deposition was influenced by precipitation and mean temperature of air, and the spatial distribution of microplastic deposition was influenced by sources and population density.

Factors affecting students' online courses learning behaviors

Online course learning is an important part of higher education curriculum. However, the factors influencing college students' online course learning behavior are poorly understood. The purpose of this study is to analyze the factors affecting college students' online course learning behavior. This study integrated the Information System Success Model, the Technology Acceptance Model, and Self-efficacy Theory to construct an online course learning acceptance model. A total of 308 college students participated from China filled out the questionnaire, and 18 of them also participated in a semi-structured interview. The structural equation model was used to analyze the research data. The empirical analysis showed that self-efficacy has a positive impact on perceived usefulness and perceived ease-of-use; Perceived usefulness, attitude, system quality, and information quality affect users' behavioral intentions positively; Perceived ease of use has a positive effect on users' attitudes and perceived usefulness; and perceived usefulness has a direct effect on users' attitudes; Furthermore, behavioral intention can predict the actual use of online courses by college students. In addition, we will discuss these results and provide recommendations. This study provides a theoretical basis for the study of online course learning acceptance and extends the technology acceptance model. The research can provide inspiration for the design of online course learning and the decision-making of management institutions, and contribute to the sustainable development of education.

Untangling the influence of abiotic and biotic factors on leaf C, N, and P stoichiometry along a desert-grassland transition zone in northern China

Plant elemental composition and stoichiometry are useful tools for understanding plant nutrient strategy and biogeochemical cycling in terrestrial ecosystems. However, no studies have examined how plant leaf carbon (C), nitrogen (N), and phosphorus (P) stoichiometry responds to abiotic and biotic factors in the fragile desert-grassland ecological transition zone in northern China. Then a systematically designed 400 km transect was established to investigate the C, N, and P stoichiometry of 870 leaf samples of 61 species from 47 plant communities in the desert-grassland transition zone. At the individual level, plant taxonomic groups and life forms rather than climate or soil factors determined the leaf C, N, and P stoichiometry. In addition, leaf C, N, and P stoichiometry (except leaf C) was significantly influenced by soil moisture content in the desert-grassland transition zone. At the community level, leaf C content showed a considerable interspecific variation (73.41 %); however, the variation in leaf N and P content, as well as C:N and C:P ratios, was mainly due to intraspecific variation, which was in turn driven by soil moisture. We suggested that intraspecific trait variation played a key role in regulating community structure and function to enhance the resistance and resilience of plant communities to climate change in the desert-grassland transition zone. Our results highlighted the role of soil moisture content as a critical parameter for modeling the biogeochemical cycling in dryland plant-soil systems.

Insights on the isolation, identification, and degradation characteristics of three bacterial strains against mandipropamid and their application potential for polluted soil remediation

Bacteria-induced biodegradation techniques have become an effective approach for removing pesticide residues from polluted soils. However, their effect on chiral fungicides must be systematically evaluated and the efficiency and risk of each chiral enantiomer must be better understood. In this study, we isolated and enriched seven bacterial strains that are able to degrade mandipropamid from contaminated soil samples. Three bacterial strains with high degradation efficiency (63.6%-73.4%) were screened and identified as Pseudomonas sp. (M01), Mycolicibacterium parafortuitum (MW05), and Stenotrophomonas maltophilia (MW09) by morphological and 16S rRNA gene sequencing analyses. The degradation characteristics of three strains (M01, MW05, and MW09) was investigated and it was revealed that pH, temperature, and initial concentration of mandipropamid significantly impacted their degradation efficiency. The optimal conditions for degradation were a nutrient source of mandipropamid and an inoculation amount of 5%. We used a Box-Behnken model experiment and an analysis of variance to determine the most suitable conditions for degrading mandipropamid at various pH, temperature, and initial concentration levels. A response surface methodology analysis showed that the three strains had the highest mandipropamid degradation efficiency (> 96%) under various conditions (pH: 7.15-7.71, temperature: 28.61-30.76 °C, initial concentration: 5.524-5.934 mg/L). Mycelial, intracellular, and extracellular enzymes also had an impact on the degradation of mandipropamid enantiomers by the three strains. In soil remediation trials, the three bacterial strains could effectively enantioselectively degrade rac-mandipropamid residues in polluted sterilized and natural soil samples (R-enantiomer was degraded faster) and influence the activity of urease and β-glucosidase in the soil. The results revealed several candidate bacterial strains for mandipropamid biodegradation and provide information on mandipropamid biological detoxification in soil environments.

Measuring sustainable development of intelligent tourism service system: analysis on the user's intention

The intelligent tourism service system will help strengthen the management of scenic spots, improve tourism efficiency, and help improve the tourism ecological environment. At present, there are few researches on intelligent tourism service system. This paper attempts to sort out the literature and build structural equation model based on UTAUT2 model (UTAUT is short for Unified Theory of Acceptance and Use of Technology) to analyze the factors that affect the users' willingness of use the intelligent tourism service system (ITSS) in scenic spots. The results show that (1) the effects of the factors affecting the users' intention to use the ITSS of tourist attractions are facilitating conditions (FC), social influence (SI), performance expectation (PE), and effort expectation (EE), (2) Both PE and EE can directly affect the user's intention to use ITSS, while EE indirectly affects the user's intention through PE. (3) SI and FC have a direct impact on the UI of ITSS. The simplicity of use on intelligent tourism application system products can significantly affect the user satisfaction index and product loyalty of the users. In addition, the usefulness factor of perception system and the risk factor of user perception system coexist, with the synergistic effect positively affects the ITSS and use behavior of the whole scenic spot. The main results provide theoretical basis and empirical support for the sustainable and efficient development of ITSS.

Investigation on anxiety and depression of different populations in the area with low incidence of New Coronavirus pneumonia and analysis of related factors

Objective

To explore the anxiety and depression status and related factors of different populations in the area with low incidence of New Coronavirus pneumonia.

Methods

The anxiety and depression of 106 residents of different ages, different places of residence and different epidemic situations in Xingtai City, Hebei Province, China were assessed from February 18, 2020 to February 20, 2020. The psychological status of different groups was evaluated by self-rating Anxiety Scale (SAS) and self-rating Depression Scale (SDS), and the questionnaire data were analyzed retrospectively. The general data of all residents were collected, and the factors affecting the mental health status of different populations were studied by multiple linear regression with the scores of depression and anxiety as dependent variables.

Result

The SAS and SDS scores of anxiety and depression were (51.79±12.11) and (57.01±11.40) respectively. The positive rates of anxiety and depression were 38.68% and 47.17%, respectively. The results of multiple linear regression analysis showed that marital status, close attention to the daily epidemic progress, and having infected and sick relatives and friends were independent risk factors affecting residents' SAS score (P<0.05). Additionally, marital status, health self-assessment and close attention to the daily epidemic progress every day were independent risk factors affecting residents' SDS score (P<0.05).

Conclusion

Residents in low-incidence areas are prone to anxiety and depression. Marital status, health self-assessment, paying attention to the progress of the epidemic every day and monitoring the disease progress in relatives and friends are independent risk factors contributing to the anxiety and depression of the residents. Corresponding protective measures should be taken to improve the local epidemic prevention and control level.

Current situation and influencing factors of disease uncertainty in parents of children with Sturge‒Weber syndrome: a retrospective study

BACKGROUND

Sturge Weber syndrome (SWS), can cause extensive capillary malformations on the face, head, trunk, and other parts of the body, and the eyes can also suffer optic nerve injury. Secondary glaucoma can cause blindness, which has the characteristics of a relatively hidden onset and unclear pathogenesis. The treatment of SWS secondary glaucoma has always been difficult, and due to the characteristics of the disease, there is uncertainty about the long-term efficacy and safety of various treatment methods for such patients.

METHODS

A total of 105 parents of children with SWS completed a self-designed general information questionnaire, a generalized anxiety questionnaire (GAD-7), a patient health questionnaire (PHQ-2), a stress perception scale (PSS-4), a simple coping scale (SCSQ) and a disease-uncertainty scale (PPUS).

RESULTS

The total uncertainty score of parents of children with SWS was 79.07 ± 13.24, and the average item score was 2.82 ± 0.47. Multiple linear regression analysis revealed that anxiety and simple coping were the main influencing factors of disease uncertainty among parents of children with SWS (P < 0.05).

CONCLUSIONS

Parents of children with SWS exhibit a high level of disease uncertainty. Medical staff should pay attention to the source of parents' disease uncertainty and provide targeted interventions, which are of great importance in reducing parents' disease uncertainty.

[Clinicopathological analysis of superior mediastinal lymph node metastases in medullary thyroid carcinoma]

Objective: To investigate the clinicopathological characteristics of superior mediastinal lymph node metastases (sMLNM) in medullary thyroid carcinoma (MTC). Methods: This retrospective analysis enrolled the patients who were treated for sMLNM of MTC in our hospital from May 2012 to January 2021. All patients were suspected of sMLNM due to preoperative imaging. According to the pathological results, the patients were divided into two groups named sMLNM group and the negative superior-mediastinal-lymph-node group. We collected and analyzed the clinical features, pathological features, pre- and post-operative calcitonin (Ctn), and carcinoembryonic antigen (CEA) levels of the two groups. Logistic regression analysis was used to analyze risk factors, and receiver operation characteristic (ROC) curves were drawn to determine the optimal cut-off values of preoperative Ctn and preoperative CEA for predicting sMLNM. Results: Among the 94 patients, 69 cases were in the sMLNM group and 25 cases were in the non-SMLNM group. Preoperative Ctn level (P=0.003), preoperative CEA level (P=0.010), distant metastasis (P=0.022), extracapsular lymph node invasion (P=0.013), the number of central lymph node metastases (P=0.002) were related to sMLNM, but the multivariate analysis did not find any independent risk factors. The optimal threshold for predicting sMLNM by pre-operative Ctn is 1500 pg/ml and AUC is 0.759 (95% CI: 0.646, 0.872). The sensitivity, specificity, positive predictive value, and negative predictive value of diagnosis are 61.2%, 77.3%, 89.1%, 39.5%, respectively. In patients who underwent mediastinal lymph node dissection through transsternal approach, the metastatic possibility of different levels from high to low were level 2R (82.3%, 28/34), level 2L (58.8%, 20/34), level 4R (58.8%, 20/34), level 3 (23.5%, 8/34), level 4L (11.8%, 4/34). Postoperative complications occurred in 41 cases (43.6%), and there was no perioperative death in all cases. 14.8% (12/81) of the patients achieved biochemical complete response (Ctn≤12 pg/ml) one month after surgery, 5 of these patients were in sMLNM group. Conclusions: For patients who have highly suspicious sMLNM through imaging, combining with preoperative Ctn diagnosis can improve the accuracy of diagnosis, especially for patients with preoperative Ctn over 1 500 pg/ml. The superior mediastinal lymph node dissection for the primary sternotomy should include at least the superior mediastinal levels 2-4 to avoid residual lesions. The strategy of surgery needs to be cautiously performed. Although the probability of biochemical cure in sMLNM cases is low, nearly 40% of patients can still benefit from the operation at the biochemical level.

Improving compliance with swallowing exercise to decrease radiotherapy-related dysphagia in patients with head and neck cancer

Objective

Dysphagia, one of the most common complications in head and neck cancer (HNC) treated with radiotherapy, can severely affect patients' quality of life. Currently, because no "gold standard" treatment exists, swallowing exercise remains the main rehabilitation strategy for dysphagia. However, patients' compliance with long-term swallowing exercise is only 40%, thus, greatly compromising outcomes. This article aims to analyze thefactors influencing swallowing exercise compliance in patients with HNC and explains strategies developed to date for improved rehabilitation outcomes.

Methods

Research studies published between 2005 and 2022 were retrieved from seven databases: PubMed, Cochrane Library, Embase, CINAHL, CNKI, Wan Fang Database, and VIP Database, and 21 articles were shortlisted and systematically reviewed.

Results

The swallowing exercise compliance in patients with HNC undergoing radiotherapy was affected by multiple factors, including socio-demographic factors, illness-associated factors, treatment-associated factors, and psychosocial factors. Regarding the interventions, current strategies mainly address psychosocial issues via developing various education programs.

Conclusions

Different factors influencing swallowing exercise compliance are important and should be observed. Measures including developing multidisciplinary teams, applying innovative equipment, refining the intervention procedure, and applying systematic theory frameworks should be performed to achieve better outcomes of compliance interventions.

Technology development and cost analysis of multiple pollutant abatement for ultra-low emission coal-fired power plants in China

The implementation of ultra-low emission (ULE) limits (SO₂: 35 mg/m³, NOx: 50 mg/m³, PM: 10 mg/m³) promoted the development of flue gas treatment technologies in China. Pollutant control technology development for Chinese coal-fired power plants was summarized and an analysis of the applicability and cost of pollutant control technologies was conducted. Detailed data were collected from 30 ultra-low emission coal-fired units across China. Based on a cost analysis model, the average unit power generation incremental costs were 0.0144 and 0.0095 CNY/(kW·hr) for SO₂ and NOx control technologies, respectively. The unit power generation incremental cost of twin spray tower technology was 7.2% higher than that of dual-loop spray tower technology. The effect of key parameters on operating cost was analyzed. The unit power generation incremental cost increased because of increments in the electricity price for SO₂ control technology and the price of the reductant in NOx control technology. With high sulfur content or NOx concentration, the unit power generation incremental cost caused by pollutant control increased, whereas the unit pollutant abatement cost decreased. However, the annual operating hours or load increased, thereby leading to a decline in unit power generation incremental cost and unit pollutant abatement cost.

[Clinical Analysis of Voriconazole Concentrations in Cerebrospinal Fluid and Blood in Patients with Ryptococcal Meningitis]

Objective

To investigate the concentrations of voriconazole (VCZ) in the central nervous system (CNS) of patients with cryptococcal meningitis and the relationship thereof.

Methods

We retrospectively analyzed the trough concentration of VCZ in the cerebrospinal fluid (CSF) and the blood of 25 adult patients who had cryptococcal meningitis, and who were not infected with HIV. We also examined patient-level characteristics that could contribute to the differences in CSF/plasma VCZ concentration ratio.

Results

The trough concentration of VCZ in plasma ranged from 0.38 to 8.56 mg/L, and the median (P 25, P 75) was 1.81 (1.40, 3.84) mg/L. The trough concentration of VCZ in CSF ranged from 0.17 to 3.92 mg/L, and the median (P 25, P 75) was 1.02 (0.54, 1.84) mg/L. The CSF VCZ trough concentration showed a slight negative correlation with the nucleated cell counts in CSF, but the correlation was not statistically significant ( r=-0.377, P=0.063). There was a positive correlation between VCZ concentrations in CSF and that in the plasma ( r=0.736, P<0.001), and the median (P 25, P 75) CSF/plasma ratio was 0.43 (0.34, 0.68). The CSF/plasma ratio did not statistically correlate with age, body surface area (BSA), radiology changes (hydrocephalus), or intracranial pressure.

Conclusion

There is a positive correlation between VCZ concentration in CSF and VCZ concentration in the plasma, and no influencing factors of CSF/plasma ratio were found.

Factors Affecting the Waiting Time from Injury to Surgery in Elderly Patients with a Cervical Spine Injury: A Japanese Multicenter Survey

OBJECTIVE

The management of cervical spine injuries in the elderly is often complicated by the presence of multiple medical comorbidities, and it is not uncommon for preoperative testing to reveal other conditions that require the postponement of surgery. However, the factors that affect the waiting time from injury to surgery have not been clarified. The purpose of this multicenter database study was to analyze the clinical features and identify the factors affecting the number of days waited between injury and surgery in elderly patients with a cervical spine injury.

METHODS

We retrospectively reviewed the case histories of 1512 Japanese patients with a cervical spinal injury, who were seen at 33 institutions. After excluding patients who were not initially receiving a surgery for cervical spinal injury, 694 patients were ultimately analyzed. Based on a multivariate mixed model, we determined the factors related to the number of days from injury to surgery.

RESULTS

The mean time from injury to surgery was 12.3 days. Multivariate analysis revealed delays of 10.7 days for a renal disorder, 7.3 days for anticoagulant use, and 15.2 days for non-surgical thoracolumbar fracture as factors prolonging wait time. In contrast, a C3 or lower spine injury was significantly associated with a shortening of 9.5 days to surgery.

CONCLUSIONS

This multicenter database study identified several factors influencing the time between injury and cervical spine surgery in elderly patients. While renal impairment, anticoagulant use, and non-surgical thoracolumbar fracture may increase the number of days to surgery, trauma to C3 or lower may expedite surgical treatment.

Size distribution, community composition, and influencing factors of bioaerosols on haze and non-haze days in a megacity in Northwest China

Bioaerosols have become a major environmental concern in recent years. In this study, the diurnal variations and size distributions of bioaerosols, as well as airborne bacterial community compositions and their influencing factors on haze and non-haze days in Xi'an, China, were compared. The results indicated that the mean bacteria and fungi concentrations on non-haze days were 1.7 and 1.4 times of those on haze days, respectively, whereas the mean total airborne microbe (TAM) concentration was higher on haze days. Bacteria concentrations were the lowest in the afternoon, and the TAM concentration exhibited a bimodal distribution with two peaks coinciding with traffic rush hours. On haze days airborne fungi was mainly attached to PM_2.5, whereas bacteria and TAM were mainly distributed in coarse PM. The relative abundance of Chao1, Shannon and Simpson indices of bacterial communities were higher in the non-haze day samples, for the reason that high PM_2.5 levels with a large specific surface area may absorb more toxic and harmful substances on haze days, which should affect microbial growth. At the generic level, the relative abundance of Rhodococcus, Paracoccus, Acinetobacter, and Kocuria on haze days was higher than that on non-haze days, indicating a higher risk of contracting pathogenic pneumonia. The results of the redundancy analysis revealed that PM_2.5 and water-soluble inorganic ions (WSIIs, NO₃^-, SO₄²⁺, and NH₄⁺) strongly affected the bacterial communities on non-haze days, especially Acinetobacter. The atmospheric oxidation capacity (O_x) had a significant effect on bacterial communities during haze episodes, which were positively correlated with Paracoccus, Deinococcus, Sphingomonas, and Rubellimicrobium and were negatively correlated with Rhodococcus. These results provide valuable data to elucidate the formation and evolution of bioaerosol between haze and non-haze events and its potential threats to human health.

Microplastic characteristic in the soil across the Tibetan Plateau

Microplastics are widely detected in terrestrial environments. However, microplastic features in the soil of remote areas are still sparse. In this study, microplastic pollution in soil across the Tibetan Plateau was systematically investigated. The results revealed that microplastic was ubiquitous in the soil of the Tibetan Plateau with an average abundance of 47.12 items/kg-dry weight (range: 5-340 items/kg). Compared with the published data of soil microplastic pollution in other regions, the microplastic pollution in the Tibetan Plateau was relatively low. Fibers represented 43.54% of microplastic particles detected, followed by fragments (32.20%) and films (23.78%). They mainly consisted of polyvinyl chloride, polyethylene, polypropylene, and polystyrene. Transparent and white microplastics were prevalent, and small microplastics (50-500 μm) occupied approximately 66% of all microplastics. High values of microplastics were found near Lhasa, Naqu, and Linzhi. Furthermore, microplastic pollution was found to be negatively related to the distance to the nearest city (p < 0.01), wind velocity (p = 0.014), altitude (p = 0.181), yet positively related to precipitation (p = 0.024). This work presents new insights into the magnitude of microplastics contamination in the soil across the Tibetan Plateau and supplies valuable data for future research on ecotoxicology, ecosystem impacts, and earth system feedback of microplastics on terrestrial ecosystems.

Prognostic factors for gastric cancer patients with different serosal types

BACKGROUND

Serosal type of gastric cancer refers to the changes caused by the infiltration of cancer tissue into the serosal layer. The serosal type observed during operation directly affects the prognosis of patients with gastric cancer. There are significant differences in the prognosis of patients with different serosal types of gastric cancer, but there is no unified standard for its risk factors in the clinic. Controlling nutritional status (CONUT) score is a risk factor for the prognosis of gastric cancer, but its impact on the prognosis of patients with different serosal types of gastric cancer is unknown.

AIM

To identify the risk factors affecting the prognosis of patients with different serosal types of gastric cancer, and to control the effect of CONUT score on the prognosis.

METHODS

A total of 326 patients who underwent radical gastrectomy at the Department of Gastrointestinal Surgery of our hospital from January 2015 to January 2017 were included in this study. According to the classification and observation of serous shape, all patients were divided into four groups: Normal and reactive type (86 cases), nodular type (88 cases), tendon type (67 cases), and colorful diffuse type (85 cases). The patients were followed until death or January 2022. The clinical and pathological indexes were recorded and Cox model prognostic survival analysis was performed to explore the prognostic risk factors for patients with different serous types of gastric cancer.

RESULTS

Cox prognostic survival analysis showed that the survival factors for normal, reactive, and nodular patients were TNM stage and CONUT (P < 0.05); those for tendon type were tumor differentiation and TNM stage (P < 0.05); and those for colorful diffuse type were tumor differentiation, TNM stage, and lymph node metastasis (P < 0.05). In patients with normal and reactive type, and nodular type, the 5-year survival rate was statistically significant between patients with low and high CONUT score (P < 0.05), while in patients with tendon type and colorful diffuse type, the 5-year survival rate did not differ significantly between patients with low score and high CONUT score (P > 0.05).

CONCLUSION

Patients with different serosal types of gastric cancer have different survival influencing factors. Clinically, the prognosis of patients with different serosal types can be predicted according to their different influencing factors. Preoperative CONUT score, as one of the indicators to evaluate the prognosis of patients with different serosal types of gastric cancer, indicates a slightly worse prognosis.

[Investigate the thyroid function of radiation workers and analysis of influence factors]

Objective: To analyze the thyroid condition and influencing factors of radiation workers, and to provide scientific basis for radiation protection management. Methods: In April 2020, 4308 radiation workers from October 1, 2017 to September 30, 2019 were collected for occupational health examination in Hangzhou Occupational Disease Prevention and Treatment Hospital, the data included basic information, Thyroid hormone level and thyroid color doppler ultrasound results. The thyroid status of radiation workers in different subgroups was compared. The influencing factors of Thyroid nodule were analyzed by multiple logistic regression. Results: 616 radiation workers had abnormal thyroid gland (14.3%, 616/4308) . The main manifestations of thyroid gland abnormality were abnormal Thyroid nodule (5.1%, 220/4308) and abnormal TSH level (7.1%, 308/4308) . Compared with the male radiation workers, the abnormal rate of Thyroid nodule, T3 and Tsh in female radiation workers was higher (P<0.05) , and the abnormal rate of Thyroid nodule, T3 and T4 increased with the increase of working age (P<0.05) . Radiation Workers in non-rated medical institutions and private medical institutions had the highest detection rate of Thyroid nodule (P<0.05) , and there was no significant difference in thyroid abnormalities among Workers (P<0.05) . By multiple logistic regression analysis, Sex (female) , age and institution type (private) were all independent risk factors for Thyroid nodule (95% CI: 1.548~2.763、1.002~1.030, P<0.05) . Conclusion: Ionizing radiation can cause thyroid damage in radiation workers, so we should pay more attention to the radiation protection management of female, high age, private and district medical organizations, so as to protect the health of radiation workers.

Difference and interplay of microbial communities, metabolic functions, trophic modes and influence factors between sludge and bulking agent in a composting matrix

The difference and interplay of microbial communities, metabolic functions and influence factors between sewage sludge and bulking agent were evaluated in 60 days composting. Results showed that fungal communities were mainly affected by pH (42.4%) and ORP (35.9%) of sludge but by VS (41.1%) and temperature (34.7%) of sawdust in a composting system. Bacterial communities were primarily affected by VS (43.5%) and C/N (34.8%) of sludge but by ORP (44.5%) and temperature (31.0%) of sawdust. Tepidimicrobium dominated in the sludge at thermophilic period, while Alcaligenes prevailed in the sawdust. Bacterial carbon metabolism was significantly higher in the sludge than that in the sawdust except carbohydrate metabolism. Saprophytic fungi were the main trophic mode both in the sludge and sawdust. Water transfer facilitated Aspergillus and Trichosporon moving from sludge to sawdust to decompose lignocellulose. Ammonia transfer promoted the migration of Alcaligenes and Pseudomonas from sludge to sawdust and facilitated ammonia assimilating.

A mixed method study to examine the mental health problems of college students who had left-behind experiences

BACKGROUND

China's rapid urbanization has created a large number of labour transferring from rural to urban areas and large numbers of college students with left-behind experience (LBE). LBE was an important influencing factor on college students' mental health.

METHODS

A mixed method involving quantitative survey and qualitative interview was emplyed to explore the influence of LBE on mental health of college students. In the quantitative survey, 1605 college students from three different universities of Shandong province in China were recruited. Their mental health status was measured using Symptom Check-list 90(SCL-90 scale) compiled by American psychologist Derogatis. In the qualitative interview, 40 college students with left-behind experience from the same three universities were interviewed.

RESULTS

The prevalence estimate of total mental health problems among left-behind students was 2.14 times higher than that among those without left-behindexperience. LBE increased the problems of somatization, obsessive-compulsion (Ocd), international sensitivity, depression, anxiety, hostility, terror, paranoia, psychoticism and other symptoms. The result of qualitative interview showed the mental health problems of the college students with left-behind experience were mainly on anxiety, depression, Ocd, interpersonal sensitive and hostility, which was consistent with the results of quantitative survey.

LIMITATION

Representativeness of the sample is the major limitation of our study. Due to rare similar studies performed in other countries, we could not compare the results in China to that in other countries.

CONCLUSION

Left-behind experience was an important factor associated with the mental health of college students. The mental health of college students with LBE needs more attention.

Absorbable aerosols based on OMI data: a case study in three provinces of Northeast China

In order to assess the status of aerosol pollution in three selected Northeast Provinces of China, Ozone Monitoring Instrument/Aura Near UV Aerosol Optical Depth and Single Scattering Albedo 1-orbit L2 Swath 13 × 24km V003 (OMAERUV) daily product data was used to evaluate (1) the ultraviolet aerosol index (UVAI) temporal and spatial distribution of the three Northeast Provinces from 2009 to 2018; (2) the potential pollution source areas of provincial capital cities; and (3) future trend changes. Furthermore, the influencing factors were also analyzed and are discussed herein. The results show that the UVAI in the Northeast Provinces exhibit an overall increasing trend, with an average annual increase rate of 2.99%. Seasonally, the UVAI increasing trend in winter is higher than in spring which in turn is higher than autumn. And summer has the least increasing trend. In addition, the external source of absorbent aerosol transmission is mainly in the southwest. Moreover, the overall UVAI remains relatively constant in the central part of the region, and increases slightly and significantly in the south and north directions. In general, spring, autumn, and winter all exhibit increasing trends in varying degrees. The difference between the forecasted and actual UVAI values in the Northeast Provinces does not exceed 10%; thus, the forecasting reliability is good. Also, UVAI has different degrees of correlation with natural factors, such as precipitation and temperature. With respect to social factors, UVAI and population density (a social factor) are positively correlated in 98.2% of the study area, demonstrating that there is a strong positive correlation between UVAI and smoke and dust emissions.

24 h urinary creatinine excretion during pregnancy and its application in appropriate estimation of 24 h urinary iodine excretion

BACKGROUND

Urinary creatinine can be used to adjust urinary iodine to evaluate iodine nutritional status during pregnancy. However, the reference intervals and impact factors of urinary creatinine are unknown.

METHODS

24 h urine creatinine concentration (24 hUCr) and spot UCr at four different time periods of the day of pregnant women from Part 1 (n = 743) were measured. Linear regression analysis was performed to identify the impact factors of 24 h urinary creatinine excretion (24 hUCrE) and obtain the estimated 24 h urinary creatinine excretion (24 hUCrE_est). Then measured urinary iodine concentration (UIC) of 24 h and at fasting of pregnant women from Part 2 (n = 325), used spot urinary iodine to creatinine concentration ratio (UIC/UCr) and 24 hUCrE_est to calculate the estimated 24 h urinary iodine excretion (24 hUIE_est), finally checked the consistency and correlation of 24 hUIE_est and 24 h urinary iodine excretion (24 hUIE).

RESULTS

In Part 1, the median 24 hUCrE was 1.24(IQR0.98-1.76)g, and the reference interval was 0.61-2.93 g. The median 24 hUCr was 0.76 (IQR0.57-1.01)g/L, and the reference interval was 0.36-1.88 g/L. Multiple linear regression results showed that pregnancy weight was an influencing factor to 24 hUCrE after adjusting by gestational weeks, age, pre-pregnancy BMI, and percentage of body fat (F = 45.029, p＜0.001). In Part 2, there was no statistically significant difference between 24 hUIE_est and 24 hUIE (Z =-0.767, p = 0.443). Using 24hUIE as the gold standard, the relative average difference in 24hUIE_est was 4.2 %, the relative average differences for UIC and UIC/UCr were 32.4 % and 37.2 %. The reference interval of 24 hUIE and 24 hUIE_est were 88.43-585.90 μg and 50.97-700.39 μg, respectively.

CONCLUSIONS

The reference intervals of 24 hUCrE, spot UCr, 24 hUIE, and 24 hUIE_est during pregnancy were established. 24 hUCrE has important application value in iodine nutrition evaluation to gain more lead time for pregnant women with iodine nutrition-related diseases.

Factors affecting the efficacy of repetitive transcranial magnetic stimulation for patients with Alzheimer's disease

Repetitive transcranial magnetic stimulation (rTMS) is a safe and non-invasive technique. In recent years, many studies have demonstrated that rTMS can improve cognitive function in Alzheimer's disease (AD) patients and has potential as a therapeutic method for AD. However, the efficacy varies greatly with different rTMS treatment regimens, which is related to the frequency, type, location, duration, intensity and focusing power of stimulation. Recent studies have shown that high-frequency stimulation is superior to low-frequency stimulation; efficacy of intermittent theta burst stimulation (iTBS) is similar to that of conventional rTMS, but iTBS treatment session is shorter and might be more acceptable for AD patients; rTMS stimulation sites targeting AD-damaged brain regions or associated networks would be more effective; short-term intensive treatment combined with long-term maintenance treatment can gain long-term efficacy; dynamic adjustment of stimulus intensity combined with the degree of cognitive impairment can enhance the efficacy; functional connection based on functional magnetic resonance imaging may improve the focusing power of rTMS. In this article, we review the factors related to the efficacy of rTMS, to provide reference for feasible rTMS therapeutic regimens of AD.

The influence of hypoglycemia on the specific quality of life in type 2 diabetes mellitus: a comparative cross-sectional study of diabetics with and without hypoglycemia in Xi'an, China

Purpose

This study aims to explore the incidence of hypoglycemia in patients with type 2 diabetes mellitus (T2DM) and the influence of hypoglycemia on the specific quality of life in T2DM patients.

Methods

It was a comparative cross-sectional study consisting of 519 T2DM patients in Xi'an, China and patients were investigated by self-reported hypoglycemia and specific quality of life questionnaires from September 2019 to January 2020. Descriptive analysis, t-test, Chi-square test, hierarchical regression analysis and stepwise multiple regression analysis were applied to assess the influence of hypoglycemia on the specific quality of life.

Results

The incidence of hypoglycemia in T2DM patients was 32.18%. The mean score of specific quality of life in diabetes without hypoglycemia was 57.33 ± 15.36 and was 61.56 ± 17.50 in those with hypoglycemia, which indicated that hypoglycemia had a serious impact on the quality of life of diabetics (t = − 5.172, p = 0.000). In the Univariate analysis of specific quality of life, age, education background, marital status, living status, duration of diabetes, monthly income per capita were independent and significant factors associated with specific quality of life of two groups of T2DM patients (p < 0.05). In the hierarchical regression analysis, the duration of the diabetes more than 11 years and the frequency of hypoglycemia more than 6 times in half a year entered the equation of specific quality of life of 519 diabetics respectively (p < 0.001). In multiple linear regression analysis, age, marital status and income all entered the regression equation of quality of life of the two groups (p < 0.05).

Conclusion

Hypoglycemia will have a serious impact on the quality of life of T2DM patients. In order to improve the living quality in diabetics, effective measurements should be taken to strengthen the management of blood glucose and to avoid hypoglycemia.

Plateau river research: spatial-temporal variations of δ18O and δd in the water of the Yarlung Tsangpo River and their controlling factors

Stable isotope technology has been widely used to trace sources and evolution of water bodies, relationships between different water bodies and pollution sources. Based on δ¹⁸O and δD data from the Yarlung Tsangpo River in 2017, this paper analyzes the composition characteristics of δ¹⁸O and δD in the river water during the low-flow, high-flow and normal-flow seasons of the entire Yarlung Tsangpo River and further reveals the spatial evolution and influencing factors. The results show that the values of δ¹⁸O, δD and d-excess were different in time and space. The δ¹⁸O, δD and d-excess values of the Yarlung Tsangpo River in the low-flow season were significantly higher than in the high-flow season. This was mainly due to weak evaporation enrichment and precipitation supply effects on the river water during the wet season. From the perspective of season change, the d-excess in the low-season is significantly higher than in the high-flow season and the normal-flow season; from the perspective of spatial change, the d-excess shows the same spatial variation trend as the δ¹⁸O, which first decreases and then increases. Based on the investigation of δ18O and δD in the main and Branch rivers of the Yarlung Tsangpo River Basin, it was found that the upper reaches of the basin were mainly supplied by snowmelt, the lower reaches were mainly supplied by rainfall.

Do bacterioplankton respond equally to different river regulations? A quantitative study in the single-dammed Yarlung Tsangpo River and the cascade-dammed Lancang River

River damming has raised controversial concerns as it simultaneously contributes to socioeconomic development but may jeopardize aquatic ecology. Since bacterioplankton catalyze vital biogeochemical reactions and play important roles in aquatic ecosystems, more attention has been paid to their responses in dammed rivers. Here, a comparative study was conducted between single-dammed (the Yarlung Tsangpo River) and cascade-dammed (the Lancang River) rivers in Southwest China to investigate whether bacterioplankton respond equally to different river regulations. Our results showed that the decreased bacterioplankton abundance and the increased α-diversity always co-occurred in reservoirs of the Yarlung Tsangpo River and the Lancang River. However, the impact of damming on bacterioplankton abundance and α-diversity were resilient in the Lancang River, which can be attributed to the repeated alterations of environmental heterogeneity in cascade damming reaches. Meanwhile, a generalized additive model (GAM) was applied to identify the important drivers affecting bacterioplankton variation. The abundance was influenced by trophic conditions, such as dissolved silicon, while α-diversity was closely related to the microbial dispersal process, such as elevation and distance-from source. And it is also noted that the bacterioplankton dispersal process was interrupted in cascade damming reaches. In addition, based on their important drivers, variations in abundance and α-diversity were also predicted by GAM. As revealed by the quantitative mutual validation between the two rivers, abundance and α-diversity in the cascade-dammed river can be predicted by their response to single-dammed river, suggesting that the impact of cascade damming on bacterioplankton can be pre-assessed by referring to the single stage damming effect. Therefore, our study provides the first trial of quantitative evidence that bacterioplankton do not respond equally to different river regulations, and the impact of cascade damming on bacterioplankton can be predicted based on single stage damming effect, which can contribute to the protection of aquatic ecology in the cascade hydropower development.

Diverting colostomy is an effective procedure for ulcerative chronic radiation proctitis patients after pelvic malignancy radiation

Background

Chronic radiation proctitis (CRP) with rectal ulcer is a common complication after pelvic malignancy radiation, and gradually deteriorating ulcers will result in severe complications such as fistula. The aim of this study was to evaluate effect of colostomy on ulcerative CRP and to identify associated influence factors with effectiveness of colostomy.

Methods

Between November 2011 to February 2019, 811 hospitalized patients were diagnosed with radiation-induced enteritis (RE) in Sun Yat-sen University Sixth Affiliated Hospital, among which 284 patients presented with rectal ulcer, and 61 ulcerative CRP patients were retrospectively collected and analyzed.

Results

The overall effective rate of colostomy on ulcerative CRP was 49.2%, with a highest effective rate of 88.2% within 12 to 24 months after colostomy. 9 (31.1%) CRP patients with ulcers were cured after colostomy and 12 (19.67%) patients restored intestinal continuity, among which including 2 (3.3%) patients ever with rectovaginal fistula. 100% (55/55) patients with rectal bleeding and 91.4% (32/35) patients with anal pain were remarkably alleviated. Additionally, multivariable analysis showed the duration of stoma [OR 1.211, 95% CI (1.060–1.382), P = 0.005] and albumin (ALB) level post-colostomy [OR 1.437, 95% CI (1.102–1.875), P = 0.007] were two independent influence factors for the effectiveness of colostomy on the rectal ulcer of CRP patients.

Conclusions

Colostomy was an effective and safe procedure for treating rectal ulcer of CRP patients, and also a potential strategy for preventing and treating fistula. Duration of stoma for 12–24 months and higher ALB level could significantly improve the effectiveness of colostomy on ulcerative CRP patients.

[Effects of occupational stress and related factors on insomnia occurrence of workers in chip manufacturing industry]

Objective: To investigate the prevenlence of insomnia on workers and related influcecing factors in chip manufacturing industry. Methods: By using cluster sampling method, 2 251 workers in chip manufacturing industry were selected as study subjects. The simple Job Demand-Control model Questionnnaire (JDC) , Effort-Reword Imbalance (ERI) Questionnnaire and Insomnia Symptoms Scale were used to evaluate JDC occupational stress, ERI occupational stress and insomnia symptoms respectively. Results: 22.6% (509/2251) workers were found high level of insomnia. The risk factors of insomnia symptoms were high score of effort and overcommitment (P< 0.05) . The risk of insomnia symptoms in high effort was 1.689 times that of low score (95%CI: 1.334-2.138) . The risk of insomnia symptoms in high overcommitment was 1.835 times that of low score (95%CI: 1.461-2.305) . The protective factors for insomnia symptoms were women, monthly income of more than 3000 yuan, college dregree or above, high work control and high reward (P<0.05) . Conclusion: The high scores of effort and overcommitment are the risk factors for insomnia symptoms of employees in manufacture electronic devices. Enterprises should take comprehensive measures to pay attention to the occurrence of insomnia symptoms among employees with high score of effort and overcommitment.

Home quarantine compliance is low in children with fever during COVID-19 epidemic

BACKGROUND

The coronavirus disease 2019 (COVID-19) outbreak began in China at the end of 2019. The disease is highly infectious. In order to prevent and control the epidemic situation, the state has issued a series of measures to guide the prevention and control of the epidemic. At the same time, it also introduced the measure of home isolation for children with fever. However, due to the nature of children, the implementation of the home isolation turned out to be quite difficult, and questions regarding the home isolation were brought out by parents when seeing doctors. For this reason, we decided to conduct this study.

AIM

To study factors that influence home quarantine compliance in children with fever during the COVID-19 epidemic.

METHODS

A total of 495 paediatric patients with respiratory tract infection and fever were selected from the general fever clinic at Xiamen Children's Hospital from February 6-27, 2020. On day 8 after the hospital visit, follow-up was conducted by telephone to evaluate the compliance of home quarantine.

RESULTS

Among the ten quarantine measures, the proportion of families adhering to keeping 1.5 m distance, proper hand hygiene, wearing masks at home, and proper cough etiquette was very low (< 30% for each measure). Our analysis showed that compliance was related to gender and age of children, gender and age of primary caregiver, number of children in the family, and intensity of information on quarantine measures. We observed that compliance increased with the age of children. Compared with children whose caregivers were young adults, children with elderly caregivers were 2.461 times more likely to show poor compliance. Furthermore, children who received intensive information on quarantine measures had significantly better compliance.

CONCLUSION

Compliance of children with fever to quarantine measures at home is low during the COVID-19 epidemic. Strengthening education on the quarantine measures is critical to improve compliance, in particular in young children with elderly caregivers.

[Progress in research of influencing factors of oral microbiome and association between oral microbiome and upper gastrointestinal cancer]

The composition of human oral microorganism is numerous and complex and is easily affected by many factors. With the development of metagenomic technology, the important role of oral microbiome in the development of tumor has attracted extensive attention. A literature retrieval was conducted through PubMed, Embase, CNKI and WanFang database for an analysis on the characteristics of oral bacteria and its association with oral cancer, esophageal cancer and gastric cancer. The results indicated that oral microbiome can be influenced by age, gender, race, and lifestyle. Specific oral bacteria were associated with high risk of upper gastrointestinal cancer, indicating a potential role of oral microbiota to be the biomarker for upper gastrointestinal cancer. This paper summarizes the progress in the research of the association between oral microbiome and upper gastrointestinal cancer, showing a new direction for the exploration of microbiological etiology of upper gastrointestinal cancer and providing scientific evidence for the optimization of early detection and treatment of upper gastrointestinal cancer.

[Analysis of abnormal results of thyroid B-ultrasonography in medical radiological workers in Nanjing, China]

Objective: To investigate the abnormal condition of thyroid B-ultrasonography in medical radiological workers and provides basis for health management of them. Methods: From January 1, 2018 to December 31, 1648 staff members exposed to medical radiation who participated in radiation health examination in all medical institutions in Nanjing to analyze their thyroid B-ultrasonography and compare the sex, age, length of service, blood pressure, blood glucose, smoking, drinking, professional and The post was analyzed statistically, and the influencing factors of thyroid B super anomaly were analyzed. Results: Among the 1 648 staff members, the abnormal rate of thyroid B-ultrasonography accounted for 39.4% (650/1648) , and the comparison of thyroid nodule, thyroid echo irregularity and thyroid cyst detection rate was statistically significant (P<0.01) . Compared with the normal group, the abnormal rate of thyroid B was statistically significant in different age groups, different injury working age groups, different posts, blood pressure and blood sugar (P<0.01) . The abnormal rate of thyroid B-ultrasound increased with the increase of age and working age (χ(2trend)=93.093、99.346, P<0.01) , especially the age over 40 and working age over 20 years increased the risk of abnormal thyroid B-ultrasound. Abnormal blood pressure and blood sugar were the risk of abnormal thyroid B-ultrasound (P<0.05) . Drinking alcohol could reduce the risk of abnormal thyroid B-ultrasound (P<0.05) . Conclusion: Medical radiation workers in Nanjing thyroid abnormalities are affected by age, working age, post, blood pressure, blood glucose, should strengthen protection, do a good job of comprehensive health management.

[Influencing factors for depressive symptoms in the elderly aged 65 years and older in 8 longevity areas in China]

Objective: To analyze influencing factors for depressive symptoms in the elderly aged 65 years and older in 8 longevity areas in China. Methods: We recruited 2 180 participants aged 65 years and older in 8 longevity areas from Healthy Aging and Biomarkers Cohort Study, a sub-cohort of the Chinese Longitudinal Healthy Longevity Survey in 2017. Multivariate logistic regression analysis was performed to evaluate the relationships of socio-demographic characteristics, behavioral lifestyle, chronic disease prevalence, functional status, family and social support with depressive symptoms in the elderly. Results: The detection rate of depression symptoms was 15.0% in the elderly aged 65 years and older in 8 longevity areas of China, and the detection rate of depression symptoms was 11.5% in men and 18.5% in women. Multivariate logistic regression analysis results showed that the detection rate of depressive symptoms was lower in the elderly who had regular physical exercises (OR=0.44, 95%CI: 0.26-0.74), frequent fish intakes (OR=0.57, 95%CI: 0.39-0.83), recreational activities (OR=0.65, 95%CI: 0.44-0.96), social activities (OR=0.28, 95%CI: 0.11-0.73) and community services (OR=0.68, 95%CI: 0.50-0.93). The elderly who were lack of sleep (OR=2.04, 95%CI: 1.49-2.80), had visual impairment (OR=1.54, 95%CI: 1.08-2.18), had gastrointestinal ulcer (OR=2.97, 95%CI: 1.53-5.77), had arthritis (OR=2.63, 95%CI: 1.61-4.32), had higher family expenditure than income (OR=1.80, 95%CI: 1.17-2.78) and were in poor economic condition (OR=4.58, 95%CI: 2.48-8.47) had higher detection rate of depressive symptoms. Conclusion: The status of doing physical exercise, fish intake in diet, social activity participation, sleep quality or vision, and the prevalence of gastrointestinal ulcers and arthritis were associated with the detection rate of depressive symptoms in the elderly.

[Characteristics and Influencing Factors of Pathogenic Bacteria in Lung Cancer Chemotherapy Combined with Nosocomial Pulmonary Infection]

BACKGROUND

The aim of this study is to explore the pathogenic bacteria type, distribution, drug resistance and influencing factors of nosocomial pulmonary infection in patients with lung cancer during chemotherapy.

METHODS

This study retrospectively analyzed the clinical data of 411 patients with lung cancer who were hospitalized in the First Affiliated Hospital of Zhejiang University Medical College from January 2017 to December 2018, and counted the incidence of nosocomial lung infection, pathogens, drug resistance and influencing factors.

RESULTS

There were 184 cases of nosocomial pulmonary infection in 411 lung cancer patients during chemotherapy, the infection rate was 44.77%. The isolated pathogens included Gram-negative bacteria, Gram-positive bacteria, viruses, fungi and tuberculosis, among which Gram-negative bacteria accounted for 37.25%, followed by virus infection, accounting for 15.69%. Pseudomonas aeruginosa and Klebsiella pneumoniae are the main Gram-negative bacteria, Staphylococcus aureus and Streptococcus pneumoniae are the common gram-positive bacteria, influenza B virus is the main virus, Candida and Aspergillus are the most common fungi. The resistance rate of Pseudomonas aeruginosa to imipenem was 26.67%, while that of Klebsiella pneumoniae to imipenem was 12.50%, and that of the main Gram-positive bacteria to vancomycin was 0.00%. Hypoproteinemia, long chemotherapy cycle, high-intensity chemotherapy, chronic obstructive pulmonary disease and basic bronchiectasis were the high risk factors of lung cancer patients with nosocomial pulmonary infection during chemotherapy (P<0.05).

CONCLUSIONS

During the chemotherapy of lung cancer patients with nosocomial pulmonary infection, the distribution and drug resistance of pathogenic bacteria have certain characteristics. Clinicians should strengthen the detection of pathogenic bacteria and their drug resistance. On the basis of symptomatic treatment, to achieve the purpose of ensuring the treatment effect and prolonging the survival period of patients, preventive measures should be taken for high-risk patients to reduce the chemotherapy cycle and intensity as much as possible to reduce the incidence of infection life.

Factors analysis on the use of key quality indicators for narrowing the gap of quality of care of breast cancer

BACKGROUND

There are differences in the quality of care among breast cancer patients. Narrowing the quality differences could be achieved by increasing the utilization rate of indicators. Here we explored key indicators that can improve the quality of care and factors that may affect the use of these indicators.

METHODS

A total of 3669 breast cancer patients were included in our retrospective study. We calculated patient quality-of-care composite score based on patient average method. Patients were divided into high- and low-quality groups according to the mean score. We obtained the indicators with large difference in utilization between the two groups. Multilevel logistic regression model was used to analyze the factors influencing quality of care and use of indicators.

RESULTS

The mean composite score was 0.802, and the number of patients in the high- and low-quality groups were 1898 and 1771, respectively. Four indicators showed a difference in utilization between the two groups of over 40%. Histological grade, pathological stage, tumor size and insurance type were the factors affecting the quality of care. In single indicator evaluation, besides the above factors, age, patient income and number of comorbidities may also affect the use of these four indicators. Number of comorbidities may have opposite effects on the use of different indicators, as does pathological stage.

CONCLUSIONS

Identifying key indicators for enhancing the quality-of-care of breast cancer patients and factors that affect the indicator adherence may provide guides for enhancing the utilization rate of these indicators in clinical practice.

Occurrence and distribution of perfluorooctane sulfonate and perfluorooctanoic acid in three major rivers of Xinjiang, China

Drinking water is a main pathway of human exposure to perfluorooctane sulfonate (PFOS) and perfluorooctanoic acid (PFOA). These two compounds have been identified in environmental waters worldwide, but little is known about their occurrence in Xinjiang. In this study, 155 water samples were obtained from 37 locations across Ulungur River, Manasi River, and Tarim River in Xinjiang, and were assessed by using liquid chromatography tandem-mass spectrometry. PFOS and PFOA were detected in over 50% of the samples with mean concentrations of 3.194 ng/L for PFOS and 3.460 ng/L for PFOA. Spatial and regional distribution differences do exist among the three analyzed rivers. PFOS and PFOA in Manasi River were observed at the highest levels (especially in M10 and M11), but no aggravation occurred from 2014 to 2017. Seasonal variations of PFOS and PFOA concentrations showed that water samples collected during summer were higher than those in other three seasons. The occurrence, levels, and distribution patterns of PFOS and PFOA were investigated in the present study, which provides useful theory and data support for human health risk assessment. The findings of the present study can be considered for controlling these water pollutants in environmental waters.

[Complications and influencing factors of pneumoconiosis patients undergoing CT guided percutaneous lung biopsy]

Objective: To investigate the safety and influencing factors of ct-guided percutaneous lung biopsy in pneumoconiosis patients. Methods: The data of 63 patients with pneumoconiosis who underwent ct-guided percutaneous lung biopsy in our hospital were studied to analyze the incidence of complications and influencing factors of percutaneous lung biopsy. Results: 63 cases of pneumoconiosis patients received CT guided percutaneous lung biopsy. There were 29 cases of complications (46.03%) , including 20 pneumothorax (37.75%) , 12 bleeding (19.05%) , and 3 cases of liquid pneumothorax (4.76%) . The single factor chi square analysis showed that there were significant differences in age, depth of focus, puncture position and puncture times (P<0.05) , and there was significant difference between the occurrence of hemorrhage and age, type of focus, size of focus, and the location of puncture site (P<0.05) . The unconditional LogisticL multiple factor regression analysis showed that the depth of the lesion was an independent risk factor for concurrency pneumothorax, and the size of the lesion was an independent risk factor for bleeding. Conclusion: Complications of CT-guided percutaneous pulmonary biopsy are mainly pneumothorax and hemorrhage. Age, focus type, focus size, focus depth, puncture site, and puncture times are all the factors of complications.

Polybrominated diphenyl ethers and alternative halogenated flame retardants in mollusks from the Chinese Bohai Sea: Levels and interspecific differences

Polybrominated diphenyl ethers (PBDEs) and alternative halogenated flame retardants (AHFRs) were measured in eleven mollusk species collected from the Chinese Bohai Sea. PBDEs and AHFRs were detected in all species, and their average total concentrations were in the range of 22.5-355 and 10.0-84.3 ng/g lipid weight, respectively. Decabromodiphenyl ether (BDE-209) and decabromodiphenylethane (DBDPE) were the dominant halogenated flame retardants (HFRs), contributing 22.5% to 73.6% and 3.1% to 38.3% of the total HFRs, respectively. The levels of PBDEs and AHFRs were moderate to high from a global perspective. Interspecific differences in the accumulation of PBDEs and AHFRs were characterized by heat map and cluster analysis. Composition profile differences were also observed, with higher proportions of AHFRs in gastropods than in bivalves. These species-specific differences in concentrations and profiles in mollusks were attributed to different species traits, including feeding habit, trophic level, and metabolic potential.

[An analysis of the evaluation results of symptom checklist 90 for female medical workers]

Objective: To evaluate the mental health of female doctors and nurses. Methods: Investigat the psychologic status of female doctors and nurses using symptom checklist 90. And statistical software was applied to analyze results of symptom checklist 90. Results: There were differences in the score of SCL-90 between doctor and nurse groups, the difference was statistically significant (P<0.05) . Negative life events (OR=2.940) , relative suffer from mental illness (OR=3.683) , shift work (OR=1.611) and heavy workload (OR=2.265) were found to risk factors for the positive of SCL-90. Conclusion: There were differences in the score of SCL-90 between doctor and nurse groups. Negative life events, relative suffer from mental illness, shift workand heavy workload are risk factors for SCL-90 positive of female doctors and nurses.